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Utilizing Ultrasound-Guided Femoral Nerve Blocks and Fascia Iliaca Compartment Blocks for Proximal Femur Fractures in the Emergency Department

Nagel, Emily Marie, RN, BSN, MICN; Gantioque, Raymund, DNP, RNFA, ACNP-BC; Taira, Taku, MD, FACEP

Section Editor(s): Wilbeck, Jennifer DNP, RN, FNP-BC, ACNP-BC, ENP-C, FAANP; Column Editor

Advanced Emergency Nursing Journal: April/June 2019 - Volume 41 - Issue 2 - p 135–144
doi: 10.1097/TME.0000000000000242

Proximal femur fractures (PFF) are one of the many common injuries that present to the emergency department (ED). The current practice for pain management utilizes systemic opioid analgesics. The use of opioids is an excellent analgesic choice, but they carry a significant burden for potential adverse effects. It is vital that providers have a variety of approaches to acute pain control. The use of femoral nerve blocks (FNBs) and fascia iliaca compartment blocks (FICB) are an alternative method of pain control in the ED. They have advantages over systemic opiates in that they do not require hemodynamic monitoring, have less adverse effects, and more importantly they induce rapid pain control with longer duration than systemic analgesics (Cross & Warkentine, 2016). This manuscript examines a review of literature and identifies the efficacy, patient safety, indications, contraindications, patient satisfaction, and ultrasound-guided FNB and FICB techniques.

California State University, Los Angeles (Ms Nagel and Dr Gantioque); LAC+USC Medical Center, Los Angeles, California (Ms Nagel and Dr Taira); Torrance Memorial Medical Center, Torrance, California (Ms Nagel); Arcadia Methodist Hospital, Arcadia, California (Dr Gantioque); and San Gabriel Valley Medical Center, San Gabriel, California (Dr Gantioque).

Corresponding Author: Emily Marie Nagel, RN, BSN, MICN, California State University, 5151 State University Dr, Los Angeles, CA 90032 (

Disclosure: The authors report no conflicts of interest.

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